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Multi-organ imaging provides an opportunity to quantify biological ageing beyond chronological age. The aim of this study is to assess organ-specific and whole-body ageing patterns and their associations with disease and lifestyle factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this large-scale study, we evaluate biological ageing patterns using 70,000 MRI scans from the UK Biobank and the German National Cohort. We employ 3D ResNet-18 models to predict chronological age from various body regions (brain, heart, liver, spine, lungs, muscle, and intestine) and the whole body. From these predictions, we derive \u201cage gaps\u201d relative to a strictly healthy reference cohort, which enables the identification of accelerated ageing patterns. We then evaluate associations with chronic diseases and lifestyle factors, and a virtual ageing framework was developed to explore counterfactual scenarios by substituting anatomical regions across subjects, quantifying local impacts on global biological age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Here we show significant associations between detected accelerated ageing and specific chronic diseases, including multiple sclerosis and chronic obstructive pulmonary disease, as well as lifestyle factors such as smoking and physical activity. Virtual substitution of anatomical regions demonstrates that local substitutions can influence global ageing patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrates that multi-organ imaging enables the detection of abnormal ageing patterns at both local and global levels. The presented framework provides a foundation for improved risk stratification and supports the development of personalised approaches to health assessment and disease prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s43856-026-01722-3","type":"journal-article","created":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T17:14:23Z","timestamp":1781370863000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Local and global patterns support medical imaging as a biomarker of ageing"],"prefix":"10.1038","volume":"6","author":[{"given":"Tamara T.","family":"Mueller","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Starck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rozaf\u00eb","family":"Llalloshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Kaissis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Ziller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Graf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Schlett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Ringhof","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Bamberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Wielp\u00fctz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"V\u00f6lzke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Leitzmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thoralf","family":"Niendorf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Keil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilian","family":"Krist","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Pischon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Karch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Berger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Kirschke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Rueckert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rickmer","family":"Braren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,13]]},"reference":[{"key":"1722_CR1","doi-asserted-by":"publisher","first-page":"R741","DOI":"10.1016\/j.cub.2012.07.024","volume":"22","author":"T Niccoli","year":"2012","unstructured":"Niccoli, T. & Partridge, L. 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